If you don't click with your therapist or psychiatrist, you have three reasonable options: name it and see whether things improve, change something about how you work together, or move to a different clinician. You are allowed to do any of these, and you don't need a dramatic reason. Fit is a normal thing to care about.
Part of our guide: Getting Started With Mental Health Care
The order usually matters. Unless you feel unsafe, it's often worth raising the problem once before leaving, because you may learn something useful either way. If you take medication, make sure your prescriptions are covered before you make a change.
If you are in crisis: if you are thinking about suicide or self-harm, call or text 988 (988 Suicide & Crisis Lifeline), call 911 or go to the nearest ER. Don't wait until you have sorted out your care.
Why the relationship is worth taking seriously
NIMH says treatment works best when you have a good relationship with your mental health professional. It calls rapport and trust essential, and research points the same way.
- A 2018 meta-analysis of 295 studies covering more than 30,000 patients found a positive link between the working relationship, often called the alliance, and therapy results (r = .278). The link held across treatment approaches.
- A review of randomized trials found that adults with mental health diagnoses who got their preferred psychosocial treatment dropped out less often and rated the alliance higher. It found no clear difference in other outcomes, including symptoms.
These findings have limits. The alliance research shows an association, so it can't prove that a better relationship causes better results. People who are improving may also feel better about their therapist. Most of this research is about therapy, and there is much less on the relationship with a prescriber. Even so, it's reasonable to treat your experience of the relationship as relevant information.
A rough patch, or a poor fit?
Discomfort isn't always a warning sign. Good therapy can touch painful topics, and it can take time to feel at ease. These patterns can help you sort it out, though no checklist settles it for everyone.
| May be worth working through | May point to a poor fit |
|---|---|
| You feel nervous or exposed, but also respected | You regularly feel judged, dismissed or talked over |
| A session stung, but you can see why it came up | You hide important things because of how they may react |
| You disagreed once about goals or pace | You keep disagreeing about goals, and nothing changes after you raise it |
| Progress feels slow, but you have a shared plan | You don't know what the plan is, even after asking |
| You wish they talked more or less | Their approach doesn't fit what you came for, and they can't adapt |
| A medication visit felt short | Your concerns about side effects or goals keep getting brushed off |
When not to wait
Some things aren't a matter of fit. If a clinician makes sexual or romantic advances, pressures you, threatens you or asks you to keep things secret from others, you can leave without a conversation. In New York, the Education Department has a professional misconduct complaint form, and the Department of Health's Office of Professional Medical Conduct investigates complaints about physicians. Rules vary by profession and state, and this isn't legal advice.
How long should you give it?
There isn't a proven number of sessions. NIMH's guidance is to talk to your therapist if you've been in treatment for what feels like a reasonable amount of time and aren't getting better, and that you might then explore other professionals or approaches. What's reasonable depends on the problem, the type of treatment and how often you meet.
A practical way to decide is to ask, "How will we know if this is working, and when should we check?" A clinician should be able to discuss this openly. Medication timing is its own question, so ask your prescriber what to expect. How Long Do Antidepressants Take to Work? covers one common example. A medication that isn't helping and a clinician who isn't a fit are different problems, and they call for different fixes.
Raising it, if you feel safe doing so
Researchers have a word for strain in the relationship: a rupture, meaning a disagreement on goals, trouble working together or a strain in the emotional bond. A meta-analysis of 11 studies linked repairing these moments with better outcomes (r = .29), with the same caution that this shows an association. A rupture doesn't have to end the work.
It doesn't have to be polished. You might say:
- "I'm not sure this is working for me, and I'd like to talk about it."
- "I leave sessions feeling unheard. Can we look at that?"
- "I'd like more structure, and more practical tools."
- "I have concerns about this medication that I don't feel we've gotten to."
Then notice how they respond. Curiosity, a willingness to adjust and a lack of defensiveness are good signs. Being open and still deciding to leave is a fine outcome. How to Give Your Therapist Honest Feedback goes deeper on these conversations.
If speaking up feels impossible, you could send a short message, or bring the words written down and read them. That counts.
If it's your psychiatrist or prescriber
The stakes are a little different, because your prescriptions may depend on this person.
- Don't stop on your own. Leaving a clinician doesn't have to mean leaving a medication. NIMH says do not stop treatment without talking to your provider.
- Check your supply. Know how many refills you have before you make the change.
- Ask for a bridge. Ask your prescriber, or your primary care provider, who will cover prescriptions until your new clinician takes over.
- Book before you leave. Where possible, schedule the new prescriber before your final visit with the current one.
Refills, Prior Authorizations and Shortages has more on the logistics, and a medication management visit is a place to discuss a plan.
How to change clinicians
- Decide what was missing. Was it style, expertise, approach or logistics? Knowing this makes the next search more focused. This guide to who does what can help if you need a different kind of clinician.
- Consider asking within the same practice. You can ask whether another clinician would suit you better, if that feels comfortable. Some people prefer a clean start elsewhere, and either is fine.
- Ask for a referral. Your current clinician may know who could fit, and asking is not rude.
- Interview the next person. Tell them what didn't work. NIMH's suggested questions cover credentials, approach and goals.
- Arrange records. See the next section.
- Close the old relationship. A brief message or a final session is enough. Check the practice's cancellation policy for upcoming appointments.
A final session can be useful, since you can ask for a summary, recommendations or what they would suggest looking for next. It's optional. You also don't owe a detailed explanation.
Your records
Under the federal HIPAA Privacy Rule, you generally have a right to inspect and get a copy of your health information. A provider must generally act on a request within 30 days, with one extension of up to 30 more, and can charge you only a reasonable, cost-based fee for your own copy.
Sending records to someone else works differently. The regulation says you can ask, in a signed written request, that a copy go to a person you name. A 2020 federal court ruling, Ciox Health v. Azar, limited that right to an electronic copy of an electronic health record and set aside HHS guidance applying the fee limit to those requests. For other records, the practice may ask you to sign an authorization.
There's one notable exception. Psychotherapy notes, the separate notes some therapists keep about session conversations, are excluded from that right. Your diagnosis, treatment plan, symptoms and progress summary aren't part of those notes, and they may be what a new clinician needs most. State law can add other rules, and your current practice can tell you what form it needs.
If this keeps happening
If you've left several clinicians, you haven't failed. Sometimes a specific approach is the problem, or the concern needs a different kind of specialist. Sometimes the difficulty of trusting anyone is part of what you're dealing with, and that's worth saying aloud to the next clinician. Leaving is also common: a meta-analysis of 669 studies put the average therapy dropout rate at about 1 in 5 clients. You don't have to disappear to end things.
If you need to start the search over, How to Choose the Right Therapist in New York is a good next step.
Finding a new fit at Mind Body Seven
If you are looking for a different clinician, the team page introduces the clinicians, and the individual therapy page describes that care. When you request a consultation, the intake team can confirm fit, scheduling and costs.
FAQs
Will my therapist be hurt or angry if I leave?
They may have feelings about it, but managing those is part of their professional job. Changing clinicians is a routine part of care, and a good clinician will want you to get what you need.
Can I see a new therapist while I still see my old one?
Sometimes, often briefly during a transition. It helps to tell both clinicians so their work doesn't pull in different directions. Your insurer may also have rules, so check if you are using benefits.
Can I go back to a clinician I left?
Often you can ask. It depends on their availability and on whether they think it's appropriate. There's nothing wrong with reaching out to ask.
My teen doesn't click with their therapist. What should I do?
Take it seriously, and ask what specifically feels off. A brief conversation with the clinician can help, ideally with your teen's input, since feeling heard by a young person matters. Rules on what a clinician can share with parents vary, so ask.
